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Non-Dipping BP CKD — ESENeph MCQ

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HardHypertensionNon-Dipping BP CKDESENeph

A patient with CKD G3b has satisfactory daytime ambulatory pressure but a nocturnal fall of only 4%, without nocturnal hypotension. Which interpretation is most defensible?

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Correct answer: D — Adverse prognostic phenotype prompting volume, sleep-apnoea and BP-profile review

Explanation lettering: E = shown as A · A = shown as B · D = shown as C · C = shown as D · B = shown as E

C is correct. A nocturnal fall below 10% is a non-dipping pattern and is common in CKD; it is associated with cardiovascular and kidney risk, but it is a phenotype rather than a single-drug prescription. Clinicians should confirm a technically adequate recording and assess sodium and volume status, obstructive sleep apnoea, autonomic disease and medication timing. A misclassifies an out-of-office pattern. B overstates chronotherapy evidence and could cause nocturnal hypotension. D ignores prognostic data. E turns a non-specific pattern into a definitive endocrine diagnosis. Treatment follows the entire ambulatory profile and individual tolerance.

Reference: KDIGO guideline for blood pressure in CKD: https://kdigo.org/guidelines/blood-pressure-in-ckd/